ABSTRACT
OBJECTIVES: Several outbreaks of serogroup B meningococcal disease have occurred among university students in recent years. In the setting of high coverage of the quadrivalent meningococcal conjugate vaccine and prior to widespread use of serogroup B meningococcal vaccines among adolescents, we conducted surveys to characterize the prevalence and molecular characteristics of meningococcal carriage among university students. METHODS: Two cross-sectional oropharyngeal carriage surveys were conducted among undergraduates at a Rhode Island university. Isolates were characterized using slide agglutination, real-time polymerase chain reaction (rt-PCR), and whole genome sequencing. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression to determine risk factors for carriage. RESULTS: A total of 1837 oropharyngeal specimens were obtained from 1478 unique participants. Overall carriage prevalence was 12.7-14.6% during the two survey rounds, with 1.8-2.6% for capsular genotype B, 0.9-1.0% for capsular genotypes C, W, or Y, and 9.9-10.8% for nongroupable strains by rt-PCR. Meningococcal carriage was associated with being male, smoking, party or club attendance, recent antibiotic use (inverse correlation), and recent respiratory infections. CONCLUSIONS: In this university setting, the majority of meningococcal carriage was due to nongroupable strains, followed by serogroup B. Further evaluation is needed to understand the dynamics of serogroup B carriage and disease among university students.
Subject(s)
Carrier State/epidemiology , Neisseria meningitidis, Serogroup B/isolation & purification , Neisseria meningitidis/isolation & purification , Students , Universities/statistics & numerical data , Antigens, Bacterial/immunology , Carrier State/microbiology , Cross-Sectional Studies , Disease Outbreaks/prevention & control , Disease Outbreaks/statistics & numerical data , Female , Genotype , Humans , Male , Meningococcal Infections/epidemiology , Meningococcal Infections/microbiology , Meningococcal Infections/prevention & control , Meningococcal Vaccines/administration & dosage , Meningococcal Vaccines/immunology , Molecular Typing , Neisseria meningitidis/genetics , Neisseria meningitidis/immunology , Neisseria meningitidis, Serogroup B/genetics , Neisseria meningitidis, Serogroup B/immunology , Oropharynx/microbiology , Poisson Distribution , Polymerase Chain Reaction , Prevalence , Rhode Island/epidemiology , Risk Factors , Serogroup , Sex Factors , Young AdultABSTRACT
The authors measured the impact of educational efforts on the number of college students who received meningococcal vaccine. First-year Brown University students from the classes of 2004 (n = 1,562) and 2005 (n = 1,518) received educational vaccine materials before they arrived on campus, whereas students from the class of 2003 (n = 1.441) did not. Students in the class of 2003, 13% (n = 184) of whom had received vaccine before their arrival on campus, served as the baseline. These educational efforts by the college health services before students arrived on campus increased the number of students immunized before campus arrival to 46% (n = 724) for the class of 2004, and 60% (n = 913) for the class of 2005. Education about the benefits of meningococcal vaccine before students' arrival on campus increased both the number of immunized students and the overall immunization rate among students.